Article

Drug Trends: Retail and Mail Order Insights

… drug trends series, we will reflect on the trends our clients experienced in 2020, providing an overall picture of both in- and out-of-network. Although 2020 proved to be a year of immense … with a 3.2% decrease in utilization per claim and a 5.9% decrease in cost per claim. Of the top therapeutic classes, ranked by cost, the largest changes occurred among opioids and … for those recovering from injuries while dealing with a pandemic and its consequences, we saw an increase in antidepressants, antipsychotics and psychotherapeutics in NEW claims. The older …
News Release

Genex Services Becomes Ticket to Work Provider

… physical and mental wellbeing. That's why Genex Services is proud to announce it has become an authorized provider of the Social Security Administration's Ticket to Work program. The … assigns a certified counselor to each “ticket holder” and will work to assess and develop an employment strategy unique to each individual. These services are designed to provide the … at Genex. “What's great about Ticket to Work is that it allows people with disabilities an opportunity to get back to work, providing the resources they need along the way, with the …
News Release

The Impact of Rutledge v PCMA on Workers' Compensation

… the Court noted that the provisions of Act 900 do not have “a connection with or reference to” an ERISA plan. The Court further noted that Act 900 does not have an impermissible connection with an ERISA plan because the state law does not “govern[s] a central matter of plan administration …
News Release

Industrial Commission of Arizona Formally Adopts 2020/2021 Fee Schedule

… fee schedule. The changes are slated to take effect on October 1, 2020. The rule started with an initial staff proposal and was revised following the public comment and hearing on June 25, … seven-day period if all of the following conditions are met: The medication was dispensed to an injured worker whose claim was initially denied. The injured worker disputed the denial by … rule to better reflect the changes in scopes of practice over time. The Commission also added an interest penalty on undisputed payments made to providers past the 30-day prompt pay time …
News Release

State-By-State Pharmacy Rule Updates Related to COVID-19

… of care for their citizens, including injured workers. Almost every state has declared an emergency in an effort to secure their share of federal disaster relief funds related to the outbreak. This declaration allows for the governors and agencies to adapt to the evolving crisis. In an effort to support social distancing, states are relaxing rules on telemedicine and allowing …
Virtual Event

The Gig Economy and Workers' Compensation [Podcast]

… three major areas: With the rise of Uber, Lyft and other ride-share companies, there has been an increase of inexperienced drivers. This drives up the frequency of claims but lowers the … and access to their benefits. Goldstein says they use a mix of traditional card mailing and an app to allow drivers to access their pharmacy benefits and notify the Fund that they were in an accident. …
Article

Connected Car Data: Your Vehicle's True Emissions

… One of the areas where these data come into play is in the identification and reporting of an accident. The first notice of loss has traditionally been the responsibility of the parties … able to determine when a loss has occurred and immediately contact the owner to help determine an appropriate repair facility based on the vehicle’s configuration, in addition to reporting the … carrier. But it’s not just the OEMs that find value in data. Diagnostic scans have become an integral part of the collision repair process and are absolutely essential to bringing a …
Article

Windshield Complexity and Their Role in ADAS Functionality

… of these systems is the vehicle’s multi-function camera that is centrally mounted behind the top of the windshield. The presence of a “smart windshield” is widely expected to be the norm by … has the potential to result in failures throughout the vehicle’s ADAS and possibly result in an unnecessary collision. In order to guarantee proper calibration, many OEM’s, including Subaru with their EyeSight System, recommend that technicians replace the windshield with an OEM part. Subaru also prohibits windshield repairs if the damage is in the area of the …
Article

Audit, Audit, Audit: Why You Should Further Scrutinize Workers’ Compensation Bills

… Auditing can take many shapes and forms but the essence of an audit is to review and verify that every line item is billed correctly and accurately. Since … For example, the same procedure would cost a different price depending if it took place in an outpatient facility or ambulatory surgical center. It can be difficult to keep track of these complex, jurisdiction-based rules, so an auditing service can come in handy to accurately classify bills. In addition to helping pay …
Article

6 Benefits of Diagnostic Imaging in Workers’ Compensation

… Diagnostic imaging helps determine if and when an injured employee can resume duties or need modified work. By tracking the healing process, … Specialty Solutions offer a one-stop-shop experience to make sure those recovering from an injury get what they need, when they need it.  Contact Us Today   …
Article

What is Credentialing? Why Should I Care?

… network providers. This monitoring checks for both federal and state exclusions and sanctions. An adverse event may result in immediate network termination or review by Coventry’s Quality … have the education and experience needed when treating individuals who have experienced an injury or illness as a result of a workplace incident or automobile accident.   View More …
White Paper

Proven track records create a winning formula for injured workers’ recoveries

… best outcomes for what went right, it’s clear that effective, high-quality medical care plays an essential role. To pull those best-performing clinicians to the front of the line when it … workers, many turn to outcomes-based networks (OBNs). These networks within networks can offer an injured worker the benefit of proven expertise and perhaps the best shot at a successful …
News Release

AvKARE Issues Voluntary Nationwide Recall of Certain Sildenafil and Trazodone Tablets

… a treatment for erectile dysfunction, is the active ingredient in Viagra and trazodone is an antidepressant medication with sedating properties that is also prescribed off-label to … blurred vision. These adverse events may be of special concern in elderly patients related to an increased risk for falls and related injuries, as well as driving impairment. The product …
Case Study

A Higher Calling

… matter the situation. As Genex case manager Stephanie learned, this includes managing care for an unlikely victim of gun violence in the most unlikely setting for a shooting to occur.   … home care and durable medical equipment and avoidance of post-operative complications yielded an approximate ROI of 4:1.   View More Stories …
Article

Premiums Written: Q2 2018 Casualty Must-Reads

… Workers’ Comp Billing Errors Could Be Costing Payors By ClaimsJournal.com ClaimsJournal wrote an article diving into Mitchell’s analysis of billing errors and how an auditing technology platform can help payors catch those mistakes. Appeared on …
Article

StateWatch: Bill Review May 2018

… In an effort to help alleviate the nation’s opioid epidemic, Bill S. 2456, also known as the … has announced an update of its list of providers who are authorized to treat injured workers under the workers’ …
Article

StateWatch: Bill Review May 2018

… In an effort to help alleviate the nation’s opioid epidemic, Bill S. 2456, also known as the … has announced an update of its list of providers who are authorized to treat injured workers under the workers’ …
Article

Top Trends in the Auto Casualty Insurance Industry - Mitchell Experts Provide Insights

… more expensive medical costs and increasing accident severity. Here are some of the top trends Mitchell’s auto casualty experts are seeing in the market that are influencing the … The auto casualty industry has reached an unprecedented juncture of market factors and technology capabilities that is creating unique … An Increasing Need for Customization in a Regulated World … Auto casualty adjusters are extremely busy and often tasked with additional duties on top of their main job of adjusting claims. Outsourcing tasks like document management, bill …
CE Webinar

Introduction to Prosthetics

… This session provides an overview of prosthetic design, components and technology. During the webinar we review …
News Release

Business Insurance: Lack of guidelines complicates COVID-19 care

… workers compensation industry, and those aiming to treat workers with COVID-19 are relying on an ever-changing list of experimental and unproven treatments.  Continue reading here. …
News Release

Risk & Insurance: The Power of a Job Description: Cut Claim Time and Prevent Reinjury

… Even when you're doing everything possible for an injured worker, a successful return-to-work transition can be jeopardized when a treating …
Podcast

Demystifying the Nuances of Specialty Bill Review Regulations

… on behalf of our customers, in that we, in specialty bill review, recommend to our customers an appropriate amount to pay for compensable medical bills. And I say compensable because … has recently undergone changes to their provider manuals, the hospital manuals, changing from an inpatient structure to a per diem structure. Florida has been quite significant recently as a … in that state. The other state I would say is a hot topic would be New Jersey because that’s an example of where Enlyte is using its on-the-ground lobbyists to effectuate policy changes and …
Article

COVID-19 P&C Industry Update: Regulations, Telemedicine, Access to Care and Testing

… Over the past few months, the property and casualty industry has experienced an unprecedented number of changes in a short period of time due to the COVID-19 pandemic. From a … The regulatory landscape went from a planned and predictable agenda to an atmosphere of executive orders, emergency bulletins and quick passage of legislation and … could now prescribe controlled substances to patients via telehealth without requiring an in-person visit first. To keep up with the latest by state, bookmark our pharmacy rules page …
Article

Technology Meets Empathy in Modern Telephonic Case Management

… while considering the human side of the equation. Understanding the factors influencing an injured employee’s behavior is critical to meeting them where they are in their recovery … central to the case management process, helping to understand all the factors that may impact an injured employee’s recovery. These include psychosocial issues and Social Determinants of …   As case management continues to evolve, striking an optimal balance between technological innovation and the indispensable human touch is crucial. …
Article

Technology & tools for employee wellness

… and company loyalty to reduce turnover and absenteeism. A study last year showed that an employee assistance program, or EAP, can have a significant return on investment, from 3:1 for … sheltered, sedentary lifestyle for many people, especially for people formerly employed in an office who transitioned to working from home. Gyms and fitness centers across the country were … including their overall mood, how well they sleep, and their ability to heal from injury. An August 2021 article from the Journal of Occupational Health concluded that long periods of …
News Release

Mitchell Congratulates 2018 mPower Award Winners

… Celebrating customers for delivering an excellent customer experience through business innovations … reduction from the prior year. That is 41,000 fewer opportunities for individuals to begin an unintended path to tolerance or addiction. Moreover, because of their outreach, WCF programs … consistently declined each month. In September 2018, cycle times for auto-related claims were an industry-leading average of 1.54 business days. PDA continues strengthening the industry by …
News Release

Mitchell International Acquires Medical Consultants Network

… innovative decision support and risk scores to aid in the identification of claims in which an IME or peer review may be appropriate. This strategic acquisition will give Mitchell and its customers access to an extensive national panel and network of providers—nearly 13,000 physicians with over 17,800 … continued Smith. “We are always looking for ways to deliver more value to our customers using an end-to-end, integrated suite of casualty solutions.” “Both Mitchell and MCN are committed to …
Article

CPT Code Changes for 2018: Things to Look Out For

… it’s time to start thinking about how these changes will impact the casualty industry. After an intensive review of the new CPT code book, 1 we’ve identified a few items that may be of … to know that though transcutaneous electrical nerve stimulation (TENS) is provided as an example, the intent of this code does not include the actual modality or performance of nerve … One of the biggest additions to the 2018 book is an entirely new section called for the Proprietary Laboratory Analysis (PLA) codes. In June 2016, …